Author: Leo
Key words: hemodialysis
One of the purposes of hemodialysis is to eliminate the excess water in the body, clinically dry weight as the standard, also known as "target weight", which is defined as the water under normal balance of weight, indicating that the patient has neither water retention, nor Dehydration of the weight, that is, hemodialysis at the end of hope to achieve weight.
Definition of dry weight: one of the purposes of hemodialysis is to eliminate the excess water in the body, clinically dry weight as the standard, also known as "target weight", which is defined as the water under normal balance of weight, indicating that patients have neither Water retention, and no weight when dehydrated, that is, hemodialysis at the end of hope to achieve weight.
First, the clinical significance of dry weight
1, dry weight is the medical staff to determine the amount of ultrafiltration, dialysis dialysis and determine the basis for dialysis time, so hemodialysis should remember their own dry weight and each time before the dialysis of the dry weight to the nursing.
2, the patient does not know dry weight, can not be a good control of water, severe cases can cause repeated heart failure, and even acute pulmonary edema death, the light will also bring difficulties to the treatment, many patients can not tolerate a lot of ultrafiltration, Low blood pressure, vomiting, muscle spasms, weakness after dialysis and so on.
3, dry weight changes: dialysis patients with dry weight and normal fat, thin, long-term intake of calories than the consumption of calories, dry weight will increase, otherwise it is reduced. After dialysis, the patient's mind, appetite improved, food intake increased, dry weight gradually increased. Dialysis should be amended to avoid excessive dehydration.
4, to the end of the renal failure of dialysis patients, the body water balance is not normal, most patients with fluid retention, dry weight can not be directly measured, can only be an estimated value, often need to go through several dialysis to be determined. Doctors should be determined as soon as possible dry weight, so that nurses in the treatment have been followed, should also be told to the weight of patients, so that patients can self-control the amount of water to obtain patient cooperation, to avoid the risk of retention and treatment of excessive ultrafiltration Causing side effects.
5, dry weight and blood pressure: about 80 to 90% of patients with dialysis kidney disease can be fully dialysis treatment, and adjust the dry weight and achieve good control. Overweight, high blood pressure control is not ideal is caused by cardiovascular disease in patients with cardiovascular complications, one of the main factors, such as cardiac hypertrophy, heart failure, cerebrovascular accident.
Second, hemodialysis how to judge their own dry weight?
1, if the body weight after dialysis can be reduced to the ideal dry weight:
1) conscious and comfortable, no eyelids, facial and both lower extremities edema.
2) no activity after breathing difficulties, no night chest tightness and wake up.
3) blood pressure after hemodialysis is normal.
4) chest X-ray film: show little shadow, lung field clear, no chest water sign.
5) echocardiography shows normal heart size.
2, if dehydrated too much, the patient may appear fatigue, thirst, dizziness, muscle twitching, dry skin, hoarse voice, dry throat, tinnitus and deafness, orbital depression, orthostatic hypotension or even shock.
Third, in order to achieve the ideal dry weight, hemodialysis during dialysis should pay attention to the following aspects:
1, every day at fixed time, the same conditions, the same scale to measure the weight.
2, the two dialysis between the weight to not more than 2-3 kg for the principle.
3, to allow weight gain upper limit reference value: 2 times a week, allowing weight gain of 1 kg / day; 3 times a week, allowing weight gain 1.5 kg / day, but also because of different base weight and different.
4, control of water intake:
1) measure daily urine output;
2) daily water intake for daily urine output +500 ml of water;
3) do not eat too salty things, or easy to dry mouth has been trying to drink water;
4) usually eat porridge noodles containing water, should be strictly controlled.
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